PDF(Pubmed)
Abstract：
Leptospirosis, a zoonotic infection prevalent in Pakistan, presents diverse clinical manifestations ranging from mild flu-like symptoms to severe multiorgan failure known as Weil\'s disease. This case study reports on a 24-year-old woman with leptospirosis complicated by acute kidney injury and hyperbilirubinemia, unresponsive to standard therapies. Despite initial treatment with antibiotics and hemodialysis, her condition deteriorated. Following a single session of plasmapheresis, marked clinical and laboratory improvements were observed. Notably, plasma exchange effectively reduced bilirubin levels, underscoring its potential benefit in severe leptospirosis. This case highlights the role of plasmapheresis as rescue therapy in critically ill patients, demonstrating significant outcomes in cases resistant to conventional management. Further research is warranted to refine guidelines on the optimal timing and frequency of plasma exchange in such settings.
摘要：
钩端螺旋体病,在巴基斯坦流行的人畜共患感染，呈现多种临床表现，从轻度流感样症状到称为Weil病的严重多器官功能衰竭。本病例报告一例24岁女性钩端螺旋体病并发急性肾损伤和高胆红素血症，对标准疗法无反应。尽管最初用抗生素和血液透析治疗，她的病情恶化。在一次血浆置换治疗后,观察到显著的临床和实验室改善.值得注意的是,血浆置换有效降低胆红素水平，强调其在严重钩端螺旋体病中的潜在益处。该病例强调了血浆置换作为危重患者抢救治疗的作用，在对常规管理有抵抗力的病例中显示出显著的结果。有必要进行进一步的研究，以完善有关此类设置中血浆交换的最佳时机和频率的指南。
